The lasting trauma of the concentration camps.

The children and grandchildren ofsurvivors may also be affected We have known for centuries that traumatic events, physical or mental, have a profound and often lasting effect on the personality. Yet somehow we keep forgetting this phenomenon: it has been rediscovered, redescribed, and renamed by each generation. War reminds us forcibly of the facts. In the past 100 years, the immediate impact of battle on the individual has been described variously as soldier's heart, effort syndrome, and irritable heart (dating from before 1900); from the first world war came shell shock, commotional and emotional shock, and the longer term picture, described as war neurosis and traumatic neurosis; still later, from the second world war, came the survivor syndrome and the concentration camp syndrome. The Korean and Vietnam wars produced formal descriptive classifications of the sequelae of exposure to violent stressors in the Diagnostic and Statistical Manual of Mental Disorders, First Edition (DSM-I) and DSM-III, but the category was omitted in DSM-II, which was written when there was no war. Currently, under the heading of post-traumatic stress disorder, the symptoms that characterise these variously named states-acute and chronic anxiety, depression, restlessness, irritability, sleeplessness, nightmares, and withdrawal from family and friends-are recognised as familiar sequelae not only of war but also of a host of more or less public events, whether accidental or intentional. These include physical and sexual abuse, rape, kidnapping, hostage taking, brainwashing, crashes, and fires. By now it may be part of common wisdom that horrific events disrupt the personality, but that knowledge somehow lives disconnectedly side by side with the belief that people "get over" such events quickly, especially if provided with a rest, a holiday in the sun, or a large cheque. One long term consequence of trauma is a greatly increased vigilance: although apparently behaving normally, people once caught in, for example, a large fire, can be forever checking out the electric wiring and the position of emergency exits. The disastrous event continues to exist actively in the mind, although it can be more or less well encapsulated or hidden. Survivors may avoid situations that they fear can break into that no go area, through sights, sounds, smells, or certain words, so that life can become increasingly restricted. Moreover, we have an inbuilt drive to understand, to make sense of our own experience, perhaps especially the apparently arbitrary. Thus we link the traumatic event with what …